Fungal infections and infestations have been with us throughout the history of humanity, scientifically dating back to the frozen remains of a man living circa 3300 B.C. who had intestinal ringworm, Trichuris trichiura.
Throughout the last half of the 20th century, virtually all human antifungals included very strong pharmaceuticals, consequently requiring prescriptions. The majority of the prescriptions were designed to treat systemic fungal infections. Given their strength, they carried many side effects. Gradually in the 1980s and 1990s OTC antifungals emerged, and along with them came the division of the FDA currently titled the Office of Nonprescription Products.
While the last 50 years have witnessed the identification of more than 30 new pathogens, many of them fungal in origin, many areas of the world are seeing new outbreaks of known fungal infections in humans due to the increase in global business and travel coupled with rising fungal resistance.
Fungi thrive in moist dark places, whether in soil, on the surface of a plant or in vivo; most anywhere there is water or life, fungi exist. Fungi include four basic types of organisms: Yeasts; Molds; Mushrooms; and Mildew.
In humans, it has been found that fungi can infect or cause an allergic or inflammatory reaction in most any part of the body, both in the immunocompetent and in the immunocompromised, once one is sensitized. The most commonly reported fungal infections are candidiasis, both Candida albicans and C. non-albicans varieties, and Aspergillus. There are 500 fungi known to infect humans, and a few of them are lethal. 40% of all deaths from nosocomial infections in the last 20 years have been caused by a fungal pathogen. Science is showing that both the number of systemic infections and drug resistance is on the rise. Once a person is sensitized to a fungus their immunity to fungal pathogens decreases over time and recurrence is often more common.
There are more than 110 therapies that have been tested in humans; a good number of them are currently less effective than when originally approved. Presently there are numerous new therapies in development; nonetheless, it should be noted that in the case of invasive or systemic disease such as aspergillosis, monotherapy has less than a 50% success rate.
Fungal spores are linked to allergic sinusitis, hypersensitivity pneumonitis and atopic dermatitis, and are often considered to be a major cofactor in these multi-factorial conditions. More than 30 million people in the U.S. have been diagnosed with asthma, and they are often sensitized to one or another variety of fungi.
Research shows that many human populations are now at risk for fungal infections that previously only occurred within more isolated populations of the world. If one couples this fact with the increase in organ transplants and comorbid disease states such as HIV/AIDS, diabetes, cancer or other diseases that compromise the immune system, which very often put individuals at higher risk of developing a life-threatening or potentially life-threatening fungal infection, there is no doubt that fungal infections are on the rise. As an example of those with comorbid illness, in 2008 more than 12.7 million people were diagnosed with cancer and some 7.6 million died of cancer, many of which during the course of their treatment had either a compromised immune system, hospitalization or an implantable device that left them susceptible to infection, whether of fungal origin or some other pathogen.